| NPI | 1447852033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11007482) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95057190) |
| 163W00000X Registered Nurse (Licence: NY 806677) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11007482) | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-02-22 |